A case report of menstrual catatonia causing delayed emergence from anaesthesia: a diagnostic dilemma

Abstract

Delayed emergence from anaesthesia is attributed to residual effects of anaesthetic or analgesic medications. Menstrual catatonia is an extremely rare cause for delayed emergence from anaesthesia which may pose diagnostic dilemmas. The diagnosis is by history and clinical examination. Neuro‒imaging may be required to rule out organic causes if the patient stays in catatonic state for a prolonged period. A 24year-old female underwent microdochotomy of left breast under general anaesthesia. Her trachea was extubated in the operating room with satisfactory respiratory parameters even though she remained sedated and not obeying commands. She remained in catatonic state in the postoperative care unit leading to diagnostic dilemmas. Ninety minutes later, she regained consciousness abruptly and started obeying commands. Her past history revealed two similar episodes associated with menstrual period.